In colorectal surgery, certain incidents can give rise to massive bleeding that cannot conveniently be terminated by suturing or cauterizing. If the presacral fascia is inadvertently entered during rectal surgery, bleeding from the presacral venous plexus and the sacral basivertebral veins may occur. Due to the high density of blood vessels and high volume of blood flow in the region, inadvertent tissue damage may result in severe blood loss which may lead to death in some cases. The urgency of the surgical procedure and the inaccessibility of the hemorrhaging site, as well as the severity of the bleeding, require that hemostatic measures of an unusual kind promptly be undertaken, as commonly used techniques such as packing the site or cauterizing the area often prove ineffective. It is known to terminate the bleeding by occluding or tamponading the vein, using a sterilized pin in the general form of a thumbtack and inserting it into the sacral vertebrae, in such a position that the pin itself or the head of the pin closes the vein. More than one bleeding site must often be occluded during these surgeries.
While this procedure has been used for a number of years, it is accompanied by a number of problems pertaining to difficulties of inserting the occluder pin. Ideally the hemorrhage occluder pin should be inserted fully so that the head of the pin rests on the fascia or bone. However, depending on the location of the bleeder, the curvature of the patient's sacrum, the configuration of the patient's pubic bone, and the hand strength of the surgeon, the pin may not be inserted fully or easily within the close confinement of the working area. On the other hand, full insertion is important to ensure that the bleeding vessels will remain occluded during critical phases of healing and that an abnormal movement, jarring or trauma will not later dislodge the hemorrhage occluder pin.
Even if the surgeon has the necessary hand strength and access to insert the pin fully by hand, the forces involved may increase the chances of tearing or lacerating the surgeon's gloves and skin, exposing the surgeon to the risk of blood-transmitted diseases, such as hepatitis or acquired immune deficiency syndrome. The surgeon might try to protect his hand or increase the insertion force with a foreign body, such as a conventional surgical clamp, but such a conventional tool is not shaped to conveniently access the bleeding site, or be positioned in the proper relationship to the pin.
Therefore, complete, certain, and safe insertion of the pin, regardless of access problems and variation in surgeon hand strength, often may not be achievable by existing devices and procedures, and so there is a need in the art for an improved apparatus and/or method for driving a hemorrhage occluder pin into a human sacrum.